ProjectSummary/Abstract Fetalalcoholspectrumdisorders(FASD)representamajorpublichealthproblemthataffectsupto2to5 percentofschool-agedchildrenintheUS.Unfortunately,onlyasmallfractionofchildrenwithFASDandtheir familiescanaccessFASD-informedinterventionsduetosignificantsystems-andfamily-levelbarriers. Researchsuggeststhatself-directedandpeer-to-peerinterventionsareacceptabletofamiliesandcanleadto significantimprovementsinparenting,childbehavior,andresourceutilization.Advancementsintechnology arefacilitatingmoreaccessibleandinteractivemethodsforself-directededucationandsupport.Theproposed projectwilldevelopandevaluatetheefficacyofanovelmobilehealth(mHealth)application(?app?)todirectly providecaregiverswithevidence-basedcontentandpeer-moderatedsupporttheycaneasilyaccessanduse toimproveoutcomesfortheirchildrenandfamilies.Theapp,currentlycalled?FMFConnect,?willbederived fromthescientifically-validatedFamiliesMovingForward(FMF)Programandwillbuildonexistingframeworks forthedevelopmentofmedicalapps.Thisprojectwillfollowasystematicapproachtothedevelopmentand evaluationoftheFMFConnectmHealthintervention,includingasmall-scalefeasibilitytrial(n=30),anda larger-scalehybridimplementation-effectivenesstrial(n=120)withcaregiversraisingchildren(ages3-12)with FASD.Implementationdatawillaidinidentifyingthepatternsofappusagethatrelatetothegreatest improvementsinchildandcaregiveroutcomes.Studyhypothesesare:1)thatcaregiverswillfindtheFMF Connectinterventionacceptable,witheasytoaccesscontentandencouragingsupportfrompeer-moderators;? 2)thatgreaterusageofspecificinterventioncomponentswillrelatetolargerimprovementsinchildand caregiveroutcomes;?3)thatcaregiverswhoreceivetheFMFConnectinterventionwillhavelargergainson childandcaregiveroutcomesrelativetoawaitlistcomparisongroup;?and4)thatanincreasein neurodevelopmentalattributionsforbehaviorwillmediateintervention-relatedimprovementsinparenting efficacyandchildbehavior.Projectfindingswillguidefurtherappdevelopmentbothintermsofcontentand technologicaladvancestooptimizeinterventioneffects.Resultsofthisstudywillfurthertheoverallstrategic aimsoftheCollaborativeInitiativeonFASD(CIFASD),whicharetoinformanddevelopeffectiveinterventions forFASD.ThisprojectwillalsobenefitfromresourcesandcollaborationswithinCIFASDtocarryoutthe proposedwork,includingrecruitmentofadiversesample,diagnosticsupport,andoutreachanddissemination. ThisisoneofthefirststudiestoempiricallytestanmHealthinterventiondeliveredbyparentswithpeer- moderatedsupport.IthasthepotentialtoreachmanyfamiliesraisingchildrenwithFASDinneedandcould reducesignificantbarrierstocare,resultinginagreaterpublichealthimpact.